Request for No Wrong Door User Seats

Complete this form for No Wrong Door system users at your organization. Please complete a form for each individual that require a user seat. All three sections need to be completed.

Note: Before submitting this user seat request form, please ensure the new user has completed the most recent No Wrong Door Annual Security Training. This required training can be found the No Wrong Door training platform. For more detailed information on accessing the training, view the instructions here

No Wrong Door New User Information

Name of the New User

First Name

Last Name

Job Title

Role of Individual

New User's Email

Does the requesting agency employ this individual?

Yes

If the individual is NOT employed by the AAA, who are they employed by?

Is this individual responsible for sending and/or receiving referrals

Yes

Is this individual responsible for entering and tracking client data, assessments, and/or service units?

Yes

When did the new user complete the required annual No Wrong Door Security Training?

Before submitting this user seat request form the new user has to complete the most recent No Wrong Door Annual Security Training

Requester Information

Agency Requesting

Requester Name

First Name

Last Name

Requester Email

Training

Would you like the DARS No Wrong Door Trainer to contact you regarding additional training?

Yes

We provide training related to No Wrong Door systems, PeerPlace, CRIA etc.

Additional information you would like to provide: